The HPO Axis and the Estrogen Threshold Hypothesis in Uterine Fibroids: Paving the Way for Novel Treatments

This activity is part of a series

Faculty

Ayman Al-Hendy, MD, PhD, FRCSC, FACOG, CCRP
Professor and Vice Chair for Research
Department of Obstetrics and Gynecology, University of Chicago
Gynecologist and Endoscopic Surgeon, UC Medical Center
Chicago, IL
Ayman Al-Hendy, MD, PhD, FRCSC, FACOG, CCRP

Dr. Ayman Al-Hendy is currently a tenured professor and Vice Chair of Research in the Department of Obstetrics and Gynecology, as well as advisor to the Dean of Medicine at Pritzker School of Medicine, University of Chicago (UC). Dr. Al-Hendy is a gynecologist and endoscopic surgeon at UC Medical Center in Chicago, Illinois with a busy practice that focuses on serving women with symptomatic uterine fibroids and premature ovarian insufficiency. Dr. Al-Hendy is double board certified by the Royal College of Surgeons of Canada and The American Board of Obstetrics and Gynecology. Dr. Al-Hendy’s medical research interests focus on developing novel therapies, including gene and stem cell therapy, for premature ovarian insufficiency, endometriosis, and particularly uterine fibroids. Dr. Al-Hendy has published more than 242 peer-reviewed publications in high-tier scientific journals, participated in more than 360 presentations in national and international meetings, and edited 5 medical books. Dr. Al-Hendy has also been elected as the 71st President of the Society for Reproductive Investigation.

Erica E. Marsh, MD, MSCI, FACOG
Vice Chair, Department of Obstetrics and Gynecology
University Diversity and Social Transformation Professor
S. Jan Behrman Collegiate Professor of Reproductive Medicine
Chief of the Division of Reproductive Endocrinology and Infertility
University of Michigan Medical School
Ann Arbor, MI
Erica E. Marsh, MD, MSCI, FACOG

Dr. Erica E. Marsh is the University Diversity and Social Transformation Professor and the S. Jan Behrman Collegiate Professor of Reproductive Medicine in the Department of Obstetrics and Gynecology at the University of Michigan Medical School as well as Chief of the division of Reproductive Endocrinology and Infertility in the department of OBGYN. She also serves as the Associate Director of the Michigan Institute of Clinical and Health Research (MICHR), and she is the founder and director of Health and Reproductive Disparities (onWHARD!) Collaborative. Dr. Marsh attended Harvard College from which she graduated magna cum laude, and Harvard Medical School where she graduated cum laude. She then completed her residency at the Integrated OBGYN Residency at the Brigham and Women’s Hospital and Massachusetts General Hospital, followed by a Reproductive Endocrinology and Infertility fellowship at the Feinberg School of Medicine at Northwestern University. After completing fellowship in 2008, Dr. Marsh joined the faculty at Feinberg, and then in 2016, she joined the University of Michigan.

Dr. Marsh has received millions of dollars in funding to support her research, which focuses on health disparities in reproductive medicine. She takes a 360° approach to her research with a focus on leveraging the strengths and expertise of community and community engagement to investigate research questions. Dr. Marsh has published significantly in the areas of fibroids, abnormal uterine bleeding, infertility, and most recently, COVID-19. Her work is currently funded by the NICHD, NIMHD, and the Chan Zuckerberg Foundation.

Statement of Need

While the exact pathogenesis of uterine fibroids remains unknown, the estrogen threshold hypothesis is an accepted theory that has led to the development of novel treatments for this condition, including gonadotropin-releasing hormone (GnRH) antagonists such as relugolix and elagolix. GnRH antagonists have been shown to be safe and effective treatments for patients with uterine fibroids, and their use can help to improve bleeding, discomfort, uterine fibroid size, and quality of life in premenopausal patients who are symptomatic. It is imperative that clinicians understand the estrogen threshold hypothesis and recognize the role of these novel treatments in the management of this condition.

In the second activity of this CME Outfitters Snack series, expert faculty will help learners to assess the role of GnRH antagonists in long-term treatment of uterine fibroids based on the latest data in alignment with the estrogen threshold hypothesis.

Learning Objective

Assess the role of GnRH antagonists in long-term treatment based on the latest data and aligned to the estrogen threshold hypothesis.

Financial Support

Supported by an educational grant from Pfizer Inc. and Sumitomo Pharma America.

Target Audience

Obstetrician-gynecologists, primary care physicians, nurse practitioners (NPs), physician associates (PAs), and nurses.

Credit Information

Jointly Accredited Provider

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Interprofessional (IPCE) 0.75

This activity was planned by and for the healthcare team, and learners will receive 0.75 Interprofessional Continuing Education (IPCE) Credit for learning and change.

Physicians (ACCME) 0.75

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Nurses (ANCC) 0.75

This activity is designated for 0.75 contact hour. Nurse practitioners can apply for AMA PRA Category 1 Credit(s)™ through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit(s)™ from Jointly Accredited Organizations. Nurse practitioners can also apply for credit through their state boards.

Note for California Nurses

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Physician Assistants (AAPA): 0.75

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ABIM MOC 0.75

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 medical knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

MIPS Improvement Activity

Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Royal College MOC

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Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process.

Dr. Al-Hendy reports the following financial relationships:

Consultant: AbbVie Inc.; Bayer; Myovant Sciences; Norvartis Pharmaceuticals Corporation; ObsEva; and Pfizer Inc.

Research Support: CrilaHealth.

Dr. Marsh reports the following financial relationships:

Consultant: Alnylam; Myovant Sciences; and Pfizer Inc.

Disclosures were obtained from the CME Outfitters, LLC staff; no disclosures to report:

  • Joshua Caballero PharmD, BCPP, FCCP (peer reviewer)
  • Morgan Stockberger, MD (planning committee)
  • Jessica Whelan, DNP, APRN, FPMHNP-BC, RN-BC (planning committee)
  • Susan H. Yarbrough, CHCP (planning committee)
  • Sandra Caballero, PharmD (planning committee)
  • Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credit

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Call us at 877.CME.PROS (877.263.7767).

SN-214-080923-90

The HPO Axis and the Estrogen Threshold Hypothesis in Uterine Fibroids: Paving the Way for Novel Treatments
Event Date: 08/09/2023 at 4:00 am EST